Dr. Jermaine Gordon’s 'Learn to Play from Home Music School' Registration Form
Fill out the form carefully for registration
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Student E-mail
example@example.com
Mobile Number
Next of kin name
First Name
Last Name
Next of kin number
Instrument
Please Select
Piano beginner
Piano intermediary
Piano advance
Drum 🥁 set
Drum percussions
Songwriting ✍️
Poetry to music 🎶
Guitar 🎸 beginner
Guitar 🎸 intermediate
Guitar 🎸 advance
Creative Writing 1
Creative writing 2
Singing lessons
How soon would you like to begin?
What two days of the week would you like to have classes? (DAY 1)
Mondays
Tuesdays
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Fridays
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Other
What two days of the week would you like to have classes? (DAY 2)
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Other
What time? (from 7am to 7:30pm)
Hour Minutes
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AM/PM Option
Preferred payent method
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Additional Comments
Choose your lessons
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Singing Lessons
The art of learning to sing by ear.
$
25.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Piano Lesson
The art of playing by ear - Piano
$
25.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Guitar Lesson
Guitar playing the modern way
$
25.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Creative Writing
The art of creative writing - poetry, story and more.
$
10.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Drum Lessons
The art of playing the drums by ear.
$
20.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Songwriting Classes
The art of songwriting.
$
12.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Poetry to Music
Using common recording software on your phone, tablets, iPad or computer, learn how to record yourself reciting your poems and add music.
$
35.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Creativity Coaching
Each session is tailored to meet the needs of the client and to help in capturing and executing their artistic vision.
$
30.00
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